To Your Health

Is the ox bile used in some digestive enzymes at risk for mad cow disease contamination?

Q. I'm concerned about the safety of the ox bile in some of my digestive enzymes because of possible contamination with mad cow disease. Could a vegetarian digestive enzyme supplement be just as effective and safer?

A. "Mad cow disease," also known as Bovine Spongiform Encephalopathy, is generally thought to have originated in herds of British cattle that ate feed made from sheep with a disease known as scrapie. Some meat by-products of these infected cows were then fed to other cows, resulting in BSE. The epidemic peaked in 1993 and since that time the use of slaughterhouse remnants in animal feed has been outlawed in much of the world.

When humans are infected, it is known as Creutzfeldt-Jakob disease. In both animals and humans the disease can only be transmitted if the brain, spinal cord, or retinal tissue of the diseased animal is eaten. This means that most food supplements derived from animal tissue, including ox bile, have virtually no chance of spreading the disease. The exceptions are those supplements derived from certain glands, such as pituitary, pineal, or hypothalamic extracts.

Bile is an important component of our digestive process. Although there are vegetarian sources for pancreatic digestive enzymes, bile is a strictly animal product apparently with no vegetarian substitute. It is produced in the liver using cholesterol as the starting material, and then stored in the gall bladder, if the gall bladder has not been surgically removed. When it is time to digest food, the gall bladder squeezes out some bile, which acts as a detergent to make the fat in food more soluble and therefore easier to digest. Bile salts are also anti-bacterial, capable of killing such organisms as Helicobacter pylori, the microbe associated with peptic ulcer.

Unfortunately some bile acids are apparently capable of damaging the cells that line the digestive tract. So far the evidence that bile acids are involved in colon cancer is largely circumstantial, but it is accepted that bile acids could promote the cancer initiation process. Thus, a supplement of ox bile should only be taken with a meal, and the amount used should be carefully regulated even if you need to divide pills into halves or quarters, in order to avoid discomfort such as diarrhea.

Although physicians are more likely to try to reduce bile production, some people desire an increase. Certain herbs such as milk thistle, dandelion root, and turmeric have a reputation for stimulating bile production and are used by herbalists to treat digestive problems.

Because bile salts have a reputation for causing stomach distress, conventional medicine seldom recommends their use. However there are case histories in which addition of bile salts generated unmistakable benefits. One case involved using bile salts to improve vitamin E absorption in a patient with cystic fibrosis, a disease in which absorption of fat-soluble vitamins is characteristically very poor. In another case fat malabsorption resulting from Crohn's disease was successfully treated with bile salts without inducing diarrhea. With careful supervision bile salt therapy can be part of the treatment of selected patients with certain conditions.

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